Primary Entry Device Design and Entry Related Complications at Laparoscopy in Obese Patients: A Systematic Review and Meta-Analysis.

Project Summary Title and Description

Primary Entry Device Design and Entry Related Complications at Laparoscopy in Obese Patients: A Systematic Review and Meta-Analysis.
Background: The first entry complications at laparoscopy in obese individuals is unclear. The role of the entry device rather than technique in the course of complications is a necessary evaluation to further understand first access injuries. Purpose: To summarise findings from both randomised and observational studies assessing first access injuries in obese patients according to the characteristics of the entry device utilised. Data Sources: Embase, Cochrane Library, Scopus, PubMed including MEDLINE, Web of Science and were searched for eligible articles published in English with no date limits. Study Selection: 2 authors screened article abstracts to retrieve trials investigating laparoscopic first access injuries with eligibility resting on studies that recruited obese individuals and providing device type with outcomes detailing all injuries sustained. Data Extraction: The screening authors extracted data documenting the obese class of patients enrolled in the trials, alongside the type of entry device employed and the resultant complications incurred in establishing abdominal entry.
Centre for Doctoral Training in Digital Health and Care, University of Bristol
Authors of Report
Miti, Chimwemwe Busuulwa, Paula Scott, Richard Bloomfield-Gadelha, Hermes 1 EPSRC Centre for Doctoral Training in Digital Health and Care, University of Bristol, 1 Cathedral Square, Trinity Street, Bristol, BS1 5DD, United Kingdom 2 Academic Specialty Trainee Registrar, Liverpool Women’s Hospital, Crown Street, LS8 7SS, Liverpool, United Kingdom 3Department of Engineering Mathematics and Bristol Robotics Laboratory, University of Bristol, Queens Road, BS8 1QU, Bristol, United Kingdom 4Department of Medical Physics, University Hospitals Bristol and Weston NHS FT, Marlborough Street, BS1 3NU, Bristol, United Kingdom ∗Corresponding author.
Methodology description
Systematic Review
Funding Source
This study was not directly funded but was conducted as part of a project towards a doctorate degree sponsored by EPSRC Funded Centre for Doctoral Training in Digital Health and Care, Bristol University

Key Questions

1. What is the frequency of resultant complications, at first entry and by entry device type, in specified obese classes of patients undergoing laparoscopic abdominal surgery.
2. Does the design of the primary entry trocar or the characteristics of its tip, influence complications at laparoscopic entry ?

Associated Extraction Forms


Associated Studies (each link opens a new tab)

Title Authors Year
Randomized control trial on effectiveness and safety of direct trocar versus Veress needle entry techniques in obese women during diagnostic laparoscopy Ikechebelu, J.I.; Eleje, G.U.; Joe-Ikechebelu, N.N.; Okafor, C.D.; Okpala, B.C.; Ugwu, E.O.; Nwachukwu, C.E.; Okoro, C.C.; Okam, P.C. 2021
Comparison of Direct Trocar Entry and Veress Needle Entry in Laparoscopic Bariatric Surgery: Randomized Controlled Trial Ertugrul, I.; Kayaalp, C.; Yagci, M.A.; Sumer, F.; Karagul, S.; Tolan, K. 2015
Experience with the optical access trocar for safe and rapid entry in the performance of laparoscopic gastric bypass Berch, B.R.; Torquati, A.; Lutfi, R.E.; Richards, W.O. 2006
Primary midline peritoneal access with optical trocar is safe and effective in morbidly obese patients Sabeti, N.; Tarnoff, M.; Kim, J.; Shikora, S. 2009
Creation of pneumoperitoneum using a bladed optical trocar in morbidly obese patients: Technique and results Bernante, P.; Foletto, M.; Toniato, A. 2008
Initial laparoscopic access using an optical trocar without pneumoperitoneum is safe and effective in the morbidly obese Rabl, C.; Palazzo, F.; Aoki, H.; Campos, G.M. 2008
Initial Trocar Placement and Abdominal Insufflation in Laparoscopic Bariatric Surgery Madan A.K.; Taddeucci R.J.; Harper J.L.; Tichansky D.S. 2008//
Initial entry via the left upper quadrant with an optical trocar in laparoscopic bariatric surgery Amiki, Manabu; Ishiyama, Yasuhiro; Harada, Tatsunosuke; Mochizuki, Ichitaro; Tomizawa, Yuki; Ito, Shingo; Oneyama, Masataka; Hara, Yoshiaki; Narita, Kazuhiro; Tachimori, Yuji; Goto, Manabu; Sekikawa, Koji; Kuba, Motoko 2022/04/01
Endoscopic threaded imaging port (EndoTIP) for laparoscopy: Experience with different body weights Ternamian, Artin M.; Deitel, Mervyn 1999//
The use of optical trocars in abdominal entry among patients with obesity - A case series Bucheeri, Marwan Mohamed; Menon, Sujit; Mhatre, Ashish; Abulsel, Abdulmenem Yahya; 2021
Bladeless optical trocar insertion technique for initial access in morbidly obese patients: Technique and results Coskun, Murat; Yuksel, Adem 2021/02/21
Feasible first trocar insertion technique in bariatric surgery: A novel technique Daldal, Emin; Dagmura, Hasan; Akba, Ahmet; Dasiran, Fatih; Bulbuloglu, Ertan 2020/12/01
Laparoscopy in morbidly obese patients Pasic Resad; Levine Ronald L ; Wolfe Jr Walter M 1999

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